Pain in the pubic bone after a caesarean section. Causes of pain in the pubic bone after childbirth

According to statistics, almost 50% of women have pain in the pubic bone after childbirth. Below we describe the main causes of this problem, as well as explain how it can be solved.

AT recent weeks During pregnancy, a woman's body changes dramatically in response to the imminent onset of childbirth. In expectant mothers, the pelvic bones diverge and soften cartilage tissue. Well, after the birth of the child, the reverse processes begin, which return the body to normal. Which explains why the pubic bone hurts after childbirth.

What do we have to do?

Many mothers wonder: What to do if it hurts pubis after childbirth, how to respond to the divergence of the bones? For starters, don't panic. As already mentioned, this process is absolutely normal. Indeed, during pregnancy, the hormone relaxin is released in the body of a woman, softening the cartilage and ligaments. Under its influence, the pubic part is stretched into pubic area which causes pain.

Especially strong impact relaxin is observed in the last weeks of pregnancy. During this period, cartilaginous tissues swell, the distance between the bones increases, and their mobility increases. These changes often cause discomfort. They also cause inconvenience at the postpartum stage, provoking pain symptoms in the area of pubic bone.

In 90% of cases, pain disappears within 1-2 weeks after childbirth. To eliminate them, you need to spare your body, follow all the doctor's recommendations, and eat right. And keep calm and good location spirit. After all, stress and anxiety create additional load on the body, slowing down its recovery.

Is there a health hazard?

In some cases, the pubic part is displaced too much, which provokes inflammation of the symphosis (pubic articulation of the pelvic bones). However, this disease can be easily cured after childbirth by adhering to the following rules:

wearing a bandage belt that fixes the pelvis and hips in the desired position;
regular intake of vitamins and minerals recommended by the doctor (especially calcium and magnesium);
reception sunbathing(for the absorption of vitamin D);
limitation of physical activity, frequent change of position (you can not sit, stand or walk for more than an hour);
consumption of food containing a large amount of calcium (nuts, dairy products, fish, etc.).

Also, treatment may be accompanied by taking painkillers and anti-inflammatory drugs under the supervision of a doctor. As far as surgery is concerned, there are very few reasons for having surgery on the pubic bone. This procedure is required by less than 1% of moms.

Orthopedist-traumatologist, surgeon of the first category, Research Institute, 2009

Pregnancy is always a huge burden on a woman's body. It especially increases in the third trimester, when the baby grows up and puts pressure on almost everything. internal organs. However, childbirth can also be a serious ordeal.

According to statistics, more than half of newly-made mothers complain that their pelvic bones hurt after childbirth. This syndrome may indicate serious problems in the body of a woman, and therefore it is not worth delaying a visit to the doctor. These issues are dealt with narrow specialist– a vertebrologist, who will not ignore any pain in the hip joint after childbirth, will prescribe a serious examination, and after receiving its results, will give recommendations for treatment.

Disappointing statistics indicate that pelvic bones hurt after childbirth, not only in women prone to diseases of the pelvis and spine. Even quite healthy ladies who lead passive image life, move little, eat malnourished and work in a sedentary job, may complain of hip pain after childbirth. The lack of movement significantly weakens the body of the expectant mother, this also applies to the pelvic bones and muscles. After delivery naturally such women may complain about unpleasant symptoms, including on:

Pulling and dull pain, which can be constant and intensifying during movements or even during sleep;
Feeling of tightness in the muscles;
Limited movement;
muscle spasm, which long time does not pass.

Immediately after the appearance of these symptoms, you should consult a doctor. He will conduct an examination, prescribe a diagnosis and find the root cause of pain.

Features and diagnostic needs

Pain in the pelvis after childbirth is a condition that, with pathology, almost never goes away on its own. Over time, discomfort can only increase, and therefore you can’t pull it, you should immediately consult a doctor. The doctor will decide what kind of research will be required to identify the cause of pelvic pain after childbirth. Among the methods used:

After conducting the necessary examination, you can make a diagnosis and establish the cause of the pain that occurs. The patient may be diagnosed with symphysitis, the severity of which will depend on the distance between pelvic bones. There are several stages of the disease: I - up to 1 cm, II - up to 1.99 cm, III - 2.0 cm or more. If the third stage is detected, then the doctor can make another diagnosis - “rupture of the pubic joint”.

Causes of pain syndrome

If after childbirth the leg hurts in the thigh and pelvic area, an examination will be required. It can reveal the displacement of the pelvic bones during childbirth. In some cases, the coccyx and pelvic bones may also be displaced. This is necessary to free the fetus to pass through birth canal. Nature intended this process to be practically painless, since the woman's body has been preparing for this for a long time. And if a woman may not notice the displacement itself, then the process of return is quite tangible, and therefore can bring a lot of suffering. Often, young mothers complain that their hips hurt after childbirth. This may indicate that:

There is a lack of calcium in the body - during gestation, in the process of delivery, calcium is simply washed out of the body, and therefore the body does not have enough resources, which is reported by pain syndromes.
Tissue softening has occurred natural process, which is due to the increase certain hormone, which is secreted by the body to calm the woman in labor. Since the tissues cannot perform the functions assigned to them, this leads to pain.
Stretching of the ligaments and muscles is a condition that can also cause discomfort.
Birth trauma - it is she who most often explains why the hip joint hurts after childbirth. Dislocation, broken bones, tissue rupture - all this can cause severe pain. An untimely appeal to the doctor can lead to the fact that the bones will grow together incorrectly. And this will already entail a change in gait.

The role of calcium in the state of the woman in labor

Already at 30–34 weeks, you can notice that the pregnant woman begins to involuntarily tilt her body back, trying to transfer weight. Nature has laid down another thing - a change in gait to a “duck”, when a woman rolls from foot to foot. But by this point future mommy already has time to get used to unpleasant sipping in the lumbar region, even to pain. They may be provoked not enough calcium. This causes the development of symphysiopathy, so the doctor who observes the pregnant woman must prescribe calcium.

Medicines strengthen bones and also reduce pain. However, you should not be zealous in taking it - the dosage is strictly observed in order to avoid negative consequences including the formation of kidney stones. The right approach to solve this problem excludes pain and after childbirth.

symphysis

If the pelvis hurts after childbirth, the cause may be a change in the structure of soft tissues - dense cartilage and symphysis, located in the area of \u200b\u200bthe pubis and pelvic bone. discrepancy bone tissue after childbirth is no longer a rarity, and such a condition can lead to the appearance of sharp and severe pains, which often do not go away, but only increase. The painful condition can be so severe that it will be difficult for a woman to walk or stand normally.

Symphysis treatment

What to do if the pelvis hurts after childbirth? Contact a vertebrologist or another doctor who will examine the patient and take rational decision on the need for treatment. Sometimes the body copes on its own, but this is in the case of minimal damage. If the pain continues for a long time after childbirth, serious treatment will be required. The doctor decides on the need:

Quite often, the doctor advises to combine bed rest with gymnastics. You should not choose exercises on your own, an osteopath should work with the patient. He also evaluates the state and decides on the possibility / impossibility of performing a group of exercises.

Preventive measures

To prevent injury during delivery, as well as the development pathological conditions, follows:

Pregnancy period - difficult process for woman. The body goes through the row various changes that take time to recover. Pain in the hip joint after childbirth frequent complaint. Learning why body changes happen can help prepare moms to spend postnatal period less painful.

occasional sharp pain just sitting or resting;
discomfort in the groin area due to physical activity;
pelvic bones hurt after childbirth, when half or a whole day is spent standing on their feet;
painful feeling during sex;
urinary incontinence (inability to hold urine when you sneeze or cough).

Causes

Why does the pelvis hurt after childbirth? The reasons may be the following:

The main reason is the separation of the pelvic bone and coccyx to free the way for the child. The pelvic bones after childbirth converge to the original position, which causes pain.
Increased weight during pregnancy also has a negative effect. Women carry a growing baby in the womb during pregnancy and the weight gradually increases. The body shows some visible changes in increased stress, including discomfort in the hip and pubis after the birth of the baby.
Another reason is the original chronic disease or arthritis.
In mothers who previously suffered from pain in the coccyx, the pelvic bones after childbirth may hurt even more.
Relaxin is a hormone that causes the bones to soften. The main action of this hormone is to relax the ligaments of the body, which helps women carry the extra weight of the child. But the ligaments of the body take a long time to restore their actual position. It affects recovery.
Moms who are unable to exercise regularly during pregnancy are exposed to greater risk have health problems.

Recovery duration

How long after childbirth does the hip joint hurt? The time of recovery and recovery of the body depends on the health of the woman. This process can take anywhere from a few weeks to six months. Those moms who had a healthy pregnancy who follow healthy diet and carry out correct mode, will be restored soon.

Other factors such as rest, care, previous injury or joint complaints and general state health, including affect the process of recovery of the hip part in the postpartum period.

Some reasons that prolong the recovery period:

Inappropriate posture of the mother when she is breastfeeding or rocking the baby in her arms.
All the daily duties of a mother, which involve other strenuous activities, can have a negative impact on physical health.

Treatment at home

If the hip bones hurt, this can be easily treated without neglecting proper rest after the pregnancy period. It is necessary to have enough time for rest, because mommy has to perform many duties. A doctor's consultation will provide proper treatment and prevention, he will tell you what to do and how.

If you are planning treatment using home remedies, then you will be helped in this:

Alternating hot and cold. Take a bath with hot water or use heating pads to relax your muscles. After that, place an ice pack on the part of the body where there is discomfort. But remember that you should not apply ice directly, it must be wrapped in a towel, and only then used.
Many mothers feel better with good massage, with oil or any other healing lotion, which acts like a lubricant and helps control correct location bones.
One can find relief from acupuncture, which also helps to relax.
Healthy diet and relaxation techniques (eg meditation) excellent tool. Nutritional supplements are possible after medical consultations to secure recovery.
Maintaining water balance.
Stabilization bands in the hips and pelvis, including support normal condition this area.

Exercises

The best choices include relaxation training in both sitting and standing positions. Regular exercise will make your life active. Suitable:

Types of exercises for muscles pelvic floor Kegels help support organ weight and body weight above the pelvis.
Non stretching yoga positions.
Walking is a great way to get back in shape.
Biking if the seat is comfortable.
Swimming that doesn't cause high pressure on the bones, but at the same time trains the muscles.

Skip Squats and Stick to Isometric Strengthening abdominal cavity(Isometric exercises are static exercises where the muscles are tensed in a fixed posture, and not through movement).

But most importantly, be sure to follow any restrictions set by your doctor.

Breathing exercises

Some breathing exercises also help in the restoration of the pelvic floor. Practice diaphragm yoga trick with healthy medical support. Here's how to do it better:

When inhaling, try to expand as much as possible. chest and belly.
Then, as you exhale, pull in your belly and lift your pelvic floor “up.”

This focus breathing method creates stability that helps with any exercise. The more relaxed you are, the better the result.

Caring for a newborn can be a time of excitement, joy, and exhaustion. New hours of sleep and responsibilities are exhausting, so be sure to take time to rest. For best effect the following recommendations should be followed:

Wearing comfortable clothes depending on the weather will make motherhood easier.
It is better to avoid shoes with high heels after pregnancy.
Wait until you stop about 4-6 weeks before you start sexual intercourse.
Learn the proper ways to hold a baby. Maintain your position large quantity pillows so that your shoulders and back do not get tired.
Proper posture during work and stress management also improve the healing process.

Relaxation - important thing for every new mother. It is an excellent home remedy for treating joint pain.

Having help from loved ones for day-to-day duties can allow mom to get adequate rest, so don't give it up.

All these relaxation techniques and exercises after the baby is born are effective ways control pain in the hip joint after childbirth and not only in it. If pelvic pain does not disappear after a long period, seek advice and help from a medical specialist to normalize joint and muscle function.

Call your doctor right away if you feel:

loss of sensation in one or both legs, or sudden weakness.
loss of sensation in the buttocks, groin, or genital area (including the bladder or anus). This can either make urination or bowel movements difficult or cause incontinence.
if the pelvic bones hurt after 4 months.

There are many reasons for the appearance of pain in the leg in the hip joint after childbirth in a woman. But all of them are associated with changes that allow the body to adapt to pregnancy and ensure the safe birth of the baby. Knowledge about the nature of the occurrence of uncomfortable sensations allows you to orient yourself in time and take steps to prevent any pathological changes.

The main causes of pelvic pain after childbirth and characteristic signs

The described condition is detected in 50% of all women giving birth. The lower back, pubic part, hip joint, coccyx, knee can also hurt. Any discomfort interferes with living and fully caring for the baby. Some recover quickly, others take time. Explain painful conditions not difficult. Among the many possible factors doctors distinguish the following provocateurs:

Features of the body. In the third trimester hormonal background future mother is changing internal systems in this way prepare for the upcoming process. Along with sex hormones in large numbers relaxin is produced. Its action leads to softening of the bones and joints of the pelvis. Becoming loose and mobile, the bones are involved in the formation of the birth canal. With a strong divergence of the pubic joint, severe pain occurs. She can disturb women for another three months after the safe birth of the baby. Over time, the discomfort goes away on its own.
Violation of vitamin and mineral metabolism. Developing fetus need a lot of phosphorus, calcium. He receives them from his mother, "withdrawing" from the bones. As a result of this, the skeletal frame gradually softens. Since during childbirth the greatest load falls on the pelvis, its elements suffer the most. This condition can provoke the appearance of persistent pain and the development of dangerous injuries.
Increasing the load on musculoskeletal system. With the growth of the fetus, the uterus, the muscles of the small bottom are stretched. lower division the spine deviates backward. The pubic, sacroiliac articulation diverges. Position is changing hip bones. When all this returns to normal, there are strong painful sensations.
Birth injury. Considered potentially dangerous appearance into the world big baby in a woman with narrow pelvis. If the process is transient, the internal space does not have time to transform and adapt to the growing load. In such situations, a rupture of the pubic joint often occurs, which causes severe sharp pains. You can get rid of them after long-term treatment or surgical intervention.
Possible diseases. Many women develop symphysitis during pregnancy. With this pathology, under the action of hormones, the cartilaginous disk is stretched, connecting the pubic bones to each other. The development of pathology is accompanied by an inflammatory process. woman experiencing severe pain while walking, when performing any, even the most insignificant load, when changing the position of the body. Discomfort is aggravated by defecation and urination. Rupture of cartilage during childbirth is rare. It requires surgical intervention, after which a long recovery period, strict bed rest.

Fighting pain syndrome begins with the elimination of the causes of its occurrence.

When to See a Doctor

If you are constantly worried about pulling or sharp pain in the pelvic area, backaches occur, which are accompanied by nausea and vomiting, increased sweating, you must make an appointment with a traumatologist or orthopedist and undergo a full examination.

Should be cause for concern severe dizziness and loss of consciousness (even short-term), vaginal bleeding, fever and chills. Is considered dangerous sharp drop blood pressure. These warning signs are - serious reason to call an ambulance.

Establishing diagnosis

If the specialist sees that the woman does not need urgent surgical intervention, he begins to question the patient in detail about the symptoms and medical history. He is interested in how pain arises - suddenly or constantly, what kind of character it has - sharp or pulling, how severe discomfort on a ten point scale. The doctor must understand what the formation of the syndrome is connected with, whether there are other factors that exacerbate or alleviate the symptoms.

After a physical examination is performed, based on its results, the specialist is able to draw preliminary conclusions and determine the range necessary examinations. As a rule, patients are issued a referral for the following diagnostic procedures:

general analysis of urine and blood:
Ultrasound of the pelvic organs;
CT or MRI.

Be sure to take swabs from the vagina to detect sexually transmitted infections. If the decoding of the analyzes does not reveal the cause of the pain, laparoscopy can be performed.

Therapy Methods

The therapeutic scheme is aimed at eliminating the provocative factor. Apply in parallel medical measures that help to stop the main symptoms of malaise. For this purpose, non-steroidal anti-inflammatory drugs ("Ibuprofen") are prescribed. In the absence of effect, analgesics are used.

When the pain spreads to the muscles, complete rest will help alleviate the condition, dry heat and physiotherapy procedures. It is imperative to replenish the reserves of calcium and vitamin D, for this it is used special diet or badas. Painful joints can be influenced through the skin, using painkillers and anti-inflammatory ointments, massage.

Treatment of pain in the pelvic bones after childbirth is necessarily supplemented by physiotherapy procedures. Transferred stress, unstable hormonal background depresses the central nervous system and changes the perception of pain. Some women may also be prescribed mild sedatives: "Glycine", "Valerian", "Motherwort" in tablets.

On the initial stage therapy, each patient must make one important decision for herself: whether she will continue breast-feeding or transfer the child to the mixture. The selection of drugs will depend on this.

Preventive measures

In order to prevent the appearance of any discomfort, it is important to learn how to properly recover after childbirth. For this you need:

Immediately after the birth of the baby, observe bed rest, minimize physical activity, if possible entrusting the care of the newborn relatives.
Wear bandages designed specifically for women who have just given birth: they limit mobility hip joint take on some of the load.
Visit an osteopath.

In an uncomplicated pregnancy, it is useful to walk a lot, walk on fresh air, take vitamin and mineral complexes, eat right: eat more foods that contain phosphorus, calcium, magnesium, iron. A good night's sleep is very helpful.

Childbirth is an amazing process that tells about the beginning of a new period in a woman's life. However, every mother remembers the pain that childbirth brought her. Despite the fact that every sadness is followed by joy, many women in labor still feel unfavorable. for a long time after the birth of the long-awaited baby. This is often associated with pelvic pain. The causes of such pain can be different processes.

Pain in the coccyx and sacrum

Pain in pelvic region can be given from the sacrum and coccyx. Many women who have survived childbirth do not distinguish pain in the sacrum and tailbone between themselves. However, these are two different, albeit related, areas. The coccyx bone consists of several rudimentary vertebrae that have grown together. The sacrum is a large triangular bone. It is located at the base of the spine and is located slightly above the coccyx. Together, these two parts make up the fixed lower vertebral section. Ligaments connect the anterior and posterior surfaces of the sacrum with the pelvic bones. They firmly hold the bones of the pelvic ring.

From the beginning of carrying the baby in the womb musculoskeletal system woman is preparing for childbirth. This is due to several factors.

The lumbar vertebrae deviate backward from the vertebral axis.
The lower limbs are removed from ilium, and the hip heads come out of the acetabulum.
The bones of the sacroiliac and pubic joints diverge slightly.
The arc of the coccygeal fold changes, and the fixed bone of the sacrum moves slightly posteriorly.

The pain in the sacrum that a woman feels after childbirth may develop due to too much strong pressure, which is on the articulation in the pelvic region.

This can happen in three situations.

Large fruit size.
Incorrect presentation of the fetus.
Too fast delivery.

Pain in the pelvis can be triggered by overstretching of the joints if the passage for the baby's head was released manually during childbirth. The nature of the pain depends on the degree of congestion of the sacrococcygeal joint. This also affects the duration of the recovery period.

There are times when pain is sacral region in women in labor associated with defecation after childbirth. Indeed, due to the expansion of the sigmoid cone, which occurs due to the accumulation stool or acute phase chronic colitis, the pain of such localization can be felt. This is a complication of constipation after childbirth.

The pelvic bones are connected in front by the symphysis, the pubic junction. The pubic symphysis is the pubic fusion of two pelvic bones with the help of a fibrocartilaginous disc. In the center there is a cavity of an articular nature, which has a liquid. The symphysis is fixed on all sides by ligaments, thanks to which the joints become strong. The pubic joint has a very limited range of motion. The width of the symphysis should be no more than one centimeter.

All damage and changes in the pubic joint are combined into one word - symphysitis. It includes expansion, stretching, divergence and many other components. Pain in the pelvic area after childbirth can occur due to all these changes, for example, due to the divergence of the pubic joint. This is the result physiological changes, which cause preparatory process to make childbirth easier. During pregnancy, the placenta and ovaries secrete relaxin, which is characterized by a relaxing effect. The female sex hormone and this substance act together, so new ones appear in the joints, and the ligaments and cartilage swell. Due to these processes, there is an increase in mobility in the pelvic joints, and the distance between the bones that form each joint increases. The pubic articulation is most susceptible to such changes, the width of which becomes five or six millimeters larger. However, sometimes the degree of magnification becomes larger. Why?

The reason for this may be symphysiopathy. This is another definition that reflects the unsatisfactory state of the pubic joint, more precisely, its relaxation.

Most often, this is considered one of the manifestations of toxicosis, when a severe lesion is observed. musculoskeletal system. Relaxation can take pathological character, which leads to a strong divergence of the joints of the pelvis. With symphysiopathy, complaints and symptoms appear if there is such a discrepancy. It can be expressed in three levels:

up to 9 millimeters;
from 10 to 20 millimeters;
more than 20 millimeters.

Since symphysiopathy can lead to a divergence of the symphysis and cause pain after childbirth, it is important to find out the reasons that lead to it. In this, the leading role is assigned to a lack of vitamins D and a failure in the balance of phosphorus and calcium. Calcium, as you know, depends on the strength of bones. Phosphorus is also needed for bone formation. In the exchange of calcium and phosphorus important role belongs to the parathyroid hormone thyroid gland. In order for the body of a pregnant woman to have required amount calcium and phosphorus and their balance, you need to eat right. If the balance is disturbed, these elements are delivered to the baby in the womb from the teeth and bones of the mother. It is clear that their condition is deteriorating because of this. Due to malabsorption of phosphorus and calcium, bone mineralization is disturbed, because there is a lack of vitamin D. The level of calcium in the blood may decrease in some diseases.

Symphysiopathy often begins to manifest itself even before the birth of a child, so a woman can be prepared for the fact that after childbirth she may face pain in the pelvic area. In the second half of carrying a child, the tension of the abdominal muscles is restrained by the ratio of the pubic bones, which is explained by the increase in the uterus. After childbirth, these muscles become flabby, and very sharply, therefore frontal bones can diverge by 20 millimeters or even more. It brings pain to the woman.

However, pain can also be caused by a rupture of the symphysis. This rarely happens. In such a situation, there is a violation of the integrity of the joint, but the situation is also associated with a divergence of the joint. The gap occurs when the divergence of the symphysis reaches the third degree. When ruptured, the iliac-sacral joints may suffer. Usually, the injury develops as a result of operative delivery or when a narrowed pelvis is combined with violent labor activity. Mechanical trauma does not have a dominant value. The tensile strength of the symphysis is about 200 kilograms. The gap is interconnected again with symphysiopathy. But inflammatory changes that occur in the pubic bones and symphysis can also play a role. Sometimes the impact can be small. mechanical impact, which can push the rupture of the weak adhesion of the ligamentous apparatus.

The tissues of the pubic joint spread slowly, so the pain when moving the legs of a woman can only intensify a couple of days after childbirth. Sometimes a woman in labor may feel sharp pain in the pubic region. At the same time, you can hear the sound of torn ligaments, then the fetal head, even a large one, quickly descends through the bone ring, which becomes much wider. The pain can be caused not only by the gap itself. The fact is that a rupture of the symphysis can be accompanied by an injury urethra and Bladder. Hematomas can also form in the pubic region and near the labia. There is a possibility of joining inflammatory process, which is called symphysis. The pain that a woman feels prompts her to take a forced position.

How to get rid of pain

In order to get rid of pain in the pelvic area after childbirth, you need to find out exact reason its occurrence. This takes time as a thorough diagnosis needs to be made. After that, the doctor will prescribe treatment. If the divergence of the pubic symphysis occurred during childbirth and pregnancy, the operation is most often not done. With the development of symphysiopathy, which is combined with a slight divergence of the symphysis, it is important to limit physical activity after childbirth. A woman needs to wear a bandage, and it is best to sleep on a special orthopedic mattress. In order to restore the balance of calcium in the body, you need to take special preparations. It is necessary that calcium is contained in them in a form digestible by the body of a woman. If the examination reveals a urogenital infection, treatment includes antibiotic therapy. The doctor also prescribes painkillers: ointments, gels, tablets and suppositories.

If the discrepancy has reached the second or third degree, it is necessary to bring the ends of the pubic bones together and force them to stay in the achieved position. For this, bed rest is prescribed. Unfortunately, it can take quite a long time - up to six weeks. This means that a woman can not only walk, but even get up. In addition, she needs to use a bandage. For the first time after childbirth, a woman is given a cold, and then physiotherapy procedures are prescribed for her. You can also use painkillers and take calcium supplements.

Prevention

Pain can be avoided, although not always. Prevention includes following several rules.

Follow a diet that is based on trace elements and minerals involved in the formation of the skeleton. Products must contain enough vitamins D.
Maintain moderate physical activity therapeutic gymnastics, designed specifically for pregnant women and aimed at strengthening the muscles and stretching the ligaments of the pelvic floor.
Long walks in the fresh air. It is desirable that a woman be exposed to ultraviolet rays.
Take a prenatal multivitamin.
Fight dysbacteriosis and diseases of the gastrointestinal tract.

Such simple measures will protect against many health problems for both mother and child.